Internal medicine
-
Case Reports
Symptomatic epiphrenic diverticulum in an older patient successfully treated nonsurgically.
Epiphrenic diverticulum is a rare condition commonly diagnosed in middle-aged adults. Symptoms include dysphagia and regurgitation, which are associated with underlying esophageal motility disorders. ⋯ The patient was successfully treated non-surgically without any complications. This case demonstrates that conservative treatment is an option for older high-risk patients.
-
Case Reports
Acute Liver Injury and Bilateral Pulmonary Artery Thrombosis due to Hypereosinophilic Syndrome: A Case Report.
A 46-year-old Japanese man was referred to our hospital because of a marked increase in his eosinophil count (22,870/μL) and elevated liver enzyme levels. Computed tomography (CT) showed thrombi measuring approximately 8 cm in both femoral veins. ⋯ Four days after starting treatment, the patient experienced sudden chest pain and cardiopulmonary arrest. CT revealed bilateral pulmonary artery thrombosis, and despite administration of a tissue plasminogen activator, the patient died.
-
Objective Radwisp™ is a fluoroscopic video analysis workstation recently developed to evaluate pulmonary circulation, thereby obviating the need for contrast medium or breath-holding. This study validated Radwisp as a diagnostic tool for acute pulmonary embolism (APE) and evaluated its potential utility in patients with symptoms of suspected APE. Methods The study included 10 patients (mean age, 69±16 years old) who were admitted to our hospital for suspected APE based on symptoms and physical examination findings between January 2020 and April 2021. ⋯ Among the residents, the sensitivity and specificity were 88% and 35%, respectively, and the positive and negative predictive values were 76% and 55%, respectively. Conclusion This study showed an initial validation of Radwisp for diagnosing APE, revealing a high sensitivity but not yet achieving a high specificity. Further studies with a larger number of cases are needed to thoroughly evaluate the diagnostic performance.